10 Things You Can Do To Improve Your Heart Health
Some key takeaways from my new book, Heart. An Owner's Guide.
I started writing this newsletter almost two years ago for one simple reason.
During each consultation with a patient, I would have to explain certain topics related to heart health, and I found myself repeating them over and over.
What should my blood pressure be?
What is a normal cholesterol?
What kind of diet should I eat?
What type of exercise should I do?
What is heart disease?
In addition to a short explanation of the topic as part of the consultation I decided to have a more comprehensive explanation I could point my patients towards.
Hence, this newsletter.
Most of the topics I write about here are inspired by questions my patients ask or mistaken beliefs that need clarification.
I have now written over 110 articles, and my initial nine newsletter subscribers have grown to over 20,000.
But while each article provides a lot of value, many of you have asked if I would write a book that provides a simple, sequential series of content explaining heart disease and how to reduce risk.
After almost two years of work, the answer to that question is ‘Yes’.
The book Heart, An Owner’s Guide was released on Thursday, May 2nd, in the UK and Ireland.
It will be released in the US on May 7th.
It is available in hardcover, Kindle and audio formats.
Today, I would like to focus on ten key takeaways from the book that will help you understand heart disease a little more and give you tangible ways to reduce your future risk.
Heart. An Owner’s Guide.
Heart Disease Starts Early In Life. Earlier Than You Think.
Most people think of heart disease as a problem for older people.
While it is true that the older you are, the higher the risk of a heart attack, the process of plaque buildup starts early in life.
How early?
Over half of all ‘healthy’ heart arteries examined before being used for a heart transplant were shown to have evidence of early plaque buildup.
The average age of these heart donors? 33 years of age.
For those aged 13 to 19, close to one in five had evidence of early plaque buildup.
Heart Disease Doesn’t Kill People. Heart Attacks Kill People.
The reason we aim to avoid heart disease is so we do not suffer a heart attack.
The goal for myself and my patients is to live a long and healthy life and die ‘with’ heart disease rather than ‘from’ heart disease.
Over a long enough time frame, almost everyone will develop heart disease.
It is a heart attack, where the plaque in your artery ruptures, causing a clot to form and stop blood flow to the heart muscle that we are trying to avoid.
The easiest way of avoiding a heart attack is by avoiding heart disease.
“If there ain’t no plaque, there ain’t no heart attack”.
The Most Important Symptom Of Heart Disease.
One of the most common questions I am asked is, “What symptoms should I look out for when it comes to heart disease?”
When you develop the symptoms of heart disease, you have reached a point where your heart arteries are severely narrowed.
That does not happen overnight.
It usually takes many years of being exposed to an uncontrolled risk factor such as high blood pressure, high LDL cholesterol or diabetes.
Therefore, waiting for symptoms is the same as waiting for advanced disease.
This is not a good plan.
What is the most important symptom, then?
No symptoms.
Do not rely on symptoms alone.
The Majority Of Early Heart Disease Is Avoidable.
Heart disease can happen to anyone.
Even if they have controlled all of their known risk factors.
However, it just happens way less often to those who have controlled their risk factors.
A single risk factor for heart disease, such as high blood pressure, can significantly increase your risk of heart disease.
But if you combine risk factors for heart disease, the risk of future heart disease increases exponentially, not linearly.
Risk factors, in combination, cause an explosion in risk.
But the inverse is also true.
Manage Risk Factors. Manage Risk.
Get Heart Disease Right. Get Everything Else Right.
About nine risk factors account for about 90% of the risk of heart attacks in males and females.
As we have already discussed, if you get these right, you get heart disease right.
But there are some added benefits.
If you get these factors right, you also considerably decrease your future risk of the other leading causes of death.
For those who have optimised their cardiovascular risk, their future risk of dementia and many cancers is also likely to reduce.
Again, there are no guarantees here, but we can seriously tilt the odds in our favour.
Almost 1 in 5 People Have A Genetic Risk Factor For Heart Disease That They Are Likely Unaware Of.
What is measured is managed.
But what is not measured cannot be managed.
Lp(a) is a genetic cholesterol particle disorder that is present in 10 to 20% of the population.
This abnormal cholesterol particle significantly increases the future risk of heart attack and stroke.
The problem is that most people are unaware of whether they have an elevated Lp(a).
If you have an early family history of heart disease, then assessing your Lp(a) is a must.
There are currently no approved therapies to selectively lower Lp(a), but that does not mean we cannot reduce risk by managing all other risk factors.
We Do A Terrible Job At Identifying & Managing High Blood Pressure.
In general, about half of all high blood pressure is undiagnosed.
Of the half that is diagnosed, about half is untreated.
Of the half that is treated, half of it is sub-optimally treated.
This is the risk factor that is responsible for the most deaths globally each year.
And we do a terrible job at finding it and treating it.
Additionally, having a once-off measurement of your blood pressure with your doctor is as close to useless as makes no difference.
You need to measure your blood pressure at home over multiple days to get a clear picture of what your blood pressure really is.
Physical Activity Is As Close To A Longevity Potion As You Can Get.
High levels of aerobic fitness are closely linked to longer lifespans.
The higher your aerobic fitness, usually measured as V02 max, the longer you are likely to live.
Compared to those in the bottom 25% of aerobic fitness, those in the top 25% are about four times less likely to die from anything over a ten-year time frame.
Do high levels of aerobic fitness sound like too much for you?
How about walking?
Compared to those who take less than 4000 steps per day, those who take 12,000 steps per day are 65% less likely to die from any cause over a 10-year period.
The equation is simple.
More Movement. Longer Life.
No Amount Of Alcohol Is Good For Your Heart.
“Red wine is good for your heart.”
Except that it isn’t.
Prior studies suggested that modest amounts of alcohol were protective, and those people lived longer than those who did not drink at all.
More recent studies have examined this question in more detail, and the relationship is clear.
For every drink you consume, the risk of various health conditions, including high blood pressure, heart disease, etc., increases.
The risk is highest for those who drink a lot.
The risk is the smallest who drink the least.
Personally, I drink alcohol.
Just very little.
And I don’t drink alcohol for my ‘heart health’.
Life is full of risks. We can never eliminate all of them.
Nor should we have to if we don’t want to.
Risk Factors For Heart Disease Are Not The Same As Having Heart Disease.
High LDL cholesterol is a risk factor for heart disease.
Having high LDL cholesterol does not mean you ‘have’ heart disease.
It does increase the odds that you will develop heart disease earlier in life, though.
The same applies to high blood pressure, smoking, diabetes, etc.
But as we mentioned already, you cannot die from a condition you do not have.
So, if you want to avoid getting heart disease, you must aggressively manage all of your risk factors.
Ideally, early in life.
Waiting for heart disease to present, either by way of a heart attack or its appearance on a heart scan, before managing your risk factors is not a good strategy.
The relationship is clear.
More risk factors. More disease.
More disease. More risk of a heart attack.
The reverse is also true.
Less risk factors. Less disease.
Less disease. Less risk of a heart attack.
Want To Learn More?
If you do these ten things right, you will be well on your way to substantially reducing your future risk of heart disease.
But if you want to get even more comprehensive insights on how to identify if you are at high risk of heart disease and how to reduce that risk, the book Heart, An Owner’s Guide goes into even more detail.
The main feedback I have gotten from those who have already read the book is that it is an ‘accessible read suitable for anyone looking to learn more about preventing heart disease’.
If that sounds like something you might be interested in, you can find the book in all good bookstores or online by clicking here or on the image below.
Best of luck on your heart health journey.
Paddy
Super summary as ever Paddy, thanks for sharing.
Always enjoy your posts thanks. Interested in your thoughts on the article below Only a small study but seemingly quite dramatic differences between the two groups (quite possibly too good to be true somehow)
https://www.mdedge.com/familymedicine/article/83345/cardiology/way-reverse-cad